
How to Do the Work – by Dr. Nicole LaPera
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We have reviewed some self-therapy books before, and they chiefly have focused on CBT and mindfulness, which are great. This one’s different.
Dr. Nicole LaPera has a bolder vision for what we can do for ourselves. Rather than giving us some worksheets for unraveling cognitive distortions or clearing up automatic negative thoughts, she bids us treat the cause, rather than the symptom.
For most of us, this will be the life we have led. Now, we cannot change the parenting style(s) we received (or didn’t), get a redo on childhood, avoid mistakes we made in our adolescence, or face adult life with the benefit of experience we gained right after we needed it most. But we can still work on those things if we just know how.
The subtitle of this book promsies that the reader can/will “recognise your patterns, heal from your past, and create your self”.
That’s accurate, for the content of the book and the advice it gives.
Dr. LaPera’s focus is on being our own best healer, and reparenting our own inner child. Giving each of us the confidence in ourself; the love and care and/but also firm-if-necessary direction that a (good) parent gives a child, and the trust that a secure child will have in the parent looking after them. Doing this for ourselves, Dr. LaPera holds, allows us to heal from traumas we went through when we perhaps didn’t quite have that, and show up for ourselves in a way that we might not have thought about before.
If the book has a weak point, it’s that many of the examples given are from Dr. LaPera’s own life and experience, so how relatable the specific examples will be to any given reader may vary. But, the principles and advices stand the same regardless.
Bottom line: if you’d like to try self-therapy on a deeper level than CBT worksheets, this book is an excellent primer.
Click here to check out How To Do The Work, and empower yourself to indeed do the work!
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From Dr. Oz to Heart Valves: A Tiny Device Charted a Contentious Path Through the FDA
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In 2013, the FDA approved an implantable device to treat leaky heart valves. Among its inventors was Mehmet Oz, the former television personality and former U.S. Senate candidate widely known as “Dr. Oz.”
In online videos, Oz has called the process that brought the MitraClip device to market an example of American medicine firing “on all cylinders,” and he has compared it to “landing a man on the moon.”
MitraClip was designed to spare patients from open-heart surgery by snaking hardware into the heart through a major vein. Its manufacturer, Abbott, said it offered new hope for people severely ill with a condition called mitral regurgitation and too frail to undergo surgery.
“It changed the face of cardiac medicine,” Oz said in a video.
But since MitraClip won FDA approval, versions of the device have been the subject of thousands of reports to the agency about malfunctions or patient injuries, as well as more than 1,100 reports of patient deaths, FDA records show. Products in the MitraClip line have been the subject of three recalls. A former employee has alleged in a federal lawsuit that Abbott promoted the device through illegal inducements to doctors and hospitals. The case is pending, and Abbott has denied illegally marketing the device.
The MitraClip story is, in many ways, a cautionary tale about the science, business, and regulation of medical devices.
Manufacturer-sponsored research on the device has long been questioned. In 2013, an outside adviser to the FDA compared some of the data marshaled in support of its approval to “poop.”
The FDA expanded its approval of MitraClip to a wider set of patients in 2019, based on a clinical trial in which Abbott was deeply involved and despite conflicting findings from another study.
In the three recalls, the first of which warned of potentially deadly consequences, neither the manufacturer nor the FDA withdrew inventory from the market. The company told doctors it was OK for them to continue using the recalled products.
In response to questions for this article, both Abbott and the FDA described MitraClip as safe and effective.
“With MitraClip, we’re addressing the needs of people with MR who often have no other options,” Abbott spokesperson Brent Tippen said. “Patients suffering from mitral regurgitation have severely limited quality of life. MitraClip can significantly improve survival, freedom for hospitalization and quality of life via a minimally invasive, now common procedure.”
An FDA spokesperson, Audra Harrison, said patient safety “is the FDA’s highest priority and at the forefront of our work in medical device regulation.”
She said reports to the FDA about malfunctions, injuries, and deaths that the device may have caused or contributed to are “consistent” with study results the FDA reviewed for its 2013 and 2019 approvals.
In other words: They were expected.
Inspiration in Italy
When a person has mitral regurgitation, blood flows backward through the mitral valve. Severe cases can lead to heart failure.
With MitraClip, flaps of the valve — known as “leaflets” — are clipped together at one or more points to achieve a tighter seal when they close. The clips are deployed via a catheter threaded through a major vein, typically from an incision in the groin. The procedure offers an alternative to connecting the patient to a heart-lung machine and repairing or replacing the mitral valve in open-heart surgery.
Oz has said in online videos that he got the idea after hearing a doctor describe a surgical technique for the mitral valve at a conference in Italy. “And on the way home that night, on a plane heading back to Columbia University, where I was on the faculty, I wrote the patent,” he told KFF Health News.
A patent obtained by Columbia in 2001, one of several associated with MitraClip, lists Oz first among the inventors.
But a Silicon Valley-based startup, Evalve, would develop the device. Evalve was later acquired by Abbott for about $400 million.
“I think the engineers and people at Evalve always cringe a little bit when they see Mehmet taking a lot of, you know, basically claiming responsibility for what was a really extraordinary team effort, and he was a small to almost no player in that team,” one of the company’s founders, cardiologist Fred St. Goar, told KFF Health News.
Oz did not respond to a request for comment on that statement.
As of 2019, the MitraClip device cost $30,000 per procedure, according to an article in a medical journal. According to the Abbott website, more than 200,000 people around the world have been treated with MitraClip.
Oz filed a financial disclosure during his unsuccessful run for the U.S. Senate in 2022 that showed him receiving hundreds of thousands of dollars in annual MitraClip royalties.
Abbott recently received FDA approval for TriClip, a variation of the MitraClip system for the heart’s tricuspid valve.
Endorsed ‘With Trepidation’
Before the FDA said yes to MitraClip in 2013, agency staffers pushed back.
Abbott had originally wanted the device approved for “patients with significant mitral regurgitation,” a relatively broad term. After the FDA objected, the company narrowed its proposal to patients at too-high risk for open-heart surgery.
Even then, in an analysis, the FDA identified “fundamental” flaws in Abbott’s data.
One example: The data compared MitraClip patients with patients who underwent open-heart surgery for valve repair — but the comparison might have been biased by differences in the expertise of doctors treating the two groups, the FDA analysis said. While MitraClip was implanted by a highly select, experienced group of interventional cardiologists, many of the doctors doing the open-heart surgeries had performed only a “very low volume” of such operations.
FDA “approval is not appropriate at this time as major questions of safety and effectiveness, as well as the overall benefit-risk profile for this device, remain unanswered,” the FDA said in a review prepared for a March 2013 meeting of a committee of outside advisers to the agency.
Some committee members expressed misgivings. “If your right shoe goes into horse poop and your left shoe goes into dog poop, it’s still poop,” cardiothoracic surgeon Craig Selzman said, according to a transcript.
The committee voted 5-4 against MitraClip on the question of whether it proved effective. But members voted 8-0 that they considered the device safe and 5-3 that the benefits of the device outweighed its risks.
Selzman voted yes on the last question “with trepidation,” he said at the time.
In October 2013, the FDA approved the MitraClip Clip Delivery System for a narrower group of patients: those with a particular type of mitral regurgitation who were considered a surgery risk.
“The reality is, there is no perfect procedure,” said Jason Rogers, an interventional cardiologist and University of California-Davis professor who is an Abbott consultant. The company referred KFF Health News to Rogers as an authority on MitraClip. He called MitraClip “extremely safe” and said some patients treated with it are “on death’s door to begin with.”
“At least you’re trying to do something for them,” he said.
Conflicting Studies
In 2019, the FDA expanded its approval of MitraClip to a wider set of patients.
The agency based that decision on a clinical trial in the United States and Canada that Abbott not only sponsored but also helped design and manage. It participated in site selection and data analysis, according to a September 2018 New England Journal of Medicine paper reporting the trial results. Some of the authors received consulting fees from Abbott, the paper disclosed.
A separate study in France reached a different conclusion. It found that, for some patients who fit the expanded profile, the device did not significantly reduce deaths or hospitalizations for heart failure over a year.
The French study, which appeared in the New England Journal of Medicine in August 2018, was funded by the government of France and Abbott. As with the North American study, some of the researchers disclosed they had received money from Abbott. However, the write-up in the journal said Abbott played no role in the design of the French trial, the selection of sites, or in data analysis.
Gregg Stone, one of the leaders of the North American study, said there were differences between patients enrolled in the two studies and how they were medicated. In addition, outcomes were better in the North American study in part because doctors in the U.S. and Canada had more MitraClip experience than their counterparts in France, Stone said.
Stone, a clinical trial specialist with a background in interventional cardiology, acknowledged skepticism toward studies sponsored by manufacturers.
“There are some people who say, ‘Oh, well, you know, these results may have been manipulated,’” he said. “But I can guarantee you that’s not the truth.”
‘Nationwide Scheme’
A former Abbott employee alleges in a lawsuit that after MitraClip won approval, the company promoted the device to doctors and hospitals using inducements such as free marketing support, the chance to participate in Abbott clinical trials, and payments for participating in “sham speaker programs.”
The former employee alleges that she was instructed to tell referring physicians that if they observed mitral regurgitation in their patients to “just send it” for a MitraClip procedure because “everything can be clipped.” She also alleges that, using a script, she was told to promote the device to hospital administrators based on financial advantages such as “growth opportunities through profitable procedures, ancillary tests, and referral streams.”
The inducements were part of a “nationwide scheme” of illegal kickbacks that defrauded government health insurance programs including Medicare and Medicaid, the lawsuit claims.
The company denied doing anything illegal and said in a court filing that “to help its groundbreaking therapy reach patients, Abbott needed to educate cardiologists and other healthcare providers.”
Those efforts are “not only routine, they are laudable — as physicians cannot use, or refer a patient to another doctor who can use, a device that they do not understand or in some cases even know about,” the company said in the filing.
Under federal law, the person who filed the suit can receive a share of any money the government recoups from Abbott. The suit was filed by a company associated with a former employee in Abbott’s Structural Heart Division, Lisa Knott. An attorney for the company declined to comment and said Knott had no comment.
Reports to the FDA
As doctors started using MitraClip, the FDA began receiving reports about malfunctions and cases in which the product might have caused or contributed to a death or an injury.
According to some reports, clips detached from valve flaps. Flaps became damaged. Procedures were aborted. Mitral leakage worsened. Doctors struggled to control the device. Clips became “entangled in chordae” — cord-like structures also known as heartstrings that connect the valve flaps to the heart muscle. Patients treated with MitraClip underwent corrective operations.
As of March 2024, the FDA had received more than 17,000 reports documenting more than 22,000 “events” involving mitral valve repair devices, FDA data shows. All but about 200 of those reports mention one iteration of MitraClip or another, a KFF Health News review of FDA data found.
Almost all the reports came from Abbott. The FDA requires manufacturers to submit reports when they learn of mishaps potentially related to their devices.
The reports are not proof that devices caused problems, and the same event might be reported multiple times. Other events may go unreported.
Despite the reports’ limitations, the FDA provides an analysis of them for the public on its website.
MitraClip’s risks weren’t a surprise.
Like the rapid-fire fine print in television ads for prescription drugs, the original product label for the device listed more than 60 types of potential complications.
Indeed, during clinical research on the device, about 6% of patients implanted with MitraClip died within 30 days, according to the label. Almost 1 in 4 — 23.6% – were dead within a year.
The FDA spokesperson, Harrison, pointed to a study originally published in 2021 in The Annals of Thoracic Surgery, based on a central registry of mitral valve procedures, that found lower rates of death after MitraClip went on the market.
“These data confirmed that the MitraClip device remains safe and effective in the real-world setting,” Harrison said.
But the study’s authors, several of whom disclosed financial or other connections to Abbott, said data was missing for more than a quarter of patients one year after the procedure.
A major measure of success would be the proportion of MitraClip patients who are alive “with an acceptable quality of life” a year after undergoing the procedure, the study said. Because such information was available for fewer than half of the living patients, “we have omitted those outcomes from this report,” the authors wrote.
If you’ve had an experience with MitraClip or another medical device and would like to tell KFF Health News about it, click here to share your story with us.
KFF Health News audience engagement producer Tarena Lofton contributed to this report.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Yes, blue light from your phone can harm your skin. A dermatologist explains
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Social media is full of claims that everyday habits can harm your skin. It’s also full of recommendations or advertisements for products that can protect you.
Now social media has blue light from our devices in its sights.
So can scrolling on our phones really damage your skin? And will applying creams or lotions help?
Here’s what the evidence says and what we should really be focusing on.
Max kegfire/Shutterstock Remind me, what actually is blue light?
Blue light is part of the visible light spectrum. Sunlight is the strongest source. But our electronic devices – such as our phones, laptops and TVs – also emit it, albeit at levels 100-1,000 times lower.
Seeing as we spend so much time using these devices, there has been some concern about the impact of blue light on our health, including on our eyes and sleep.
Now, we’re learning more about the impact of blue light on our skin.
How does blue light affect the skin?
The evidence for blue light’s impact on skin is still emerging. But there are some interesting findings.
1. Blue light can increase pigmentation
Studies suggest exposure to blue light can stimulate production of melanin, the natural skin pigment that gives skin its colour.
So too much blue light can potentially worsen hyperpigmentation – overproduction of melanin leading to dark spots on the skin – especially in people with darker skin.
Blue light can worsen dark spots on the skin caused by overproduction of melanin. DUANGJAN J/Shutterstock 2. Blue light can give you wrinkles
Some research suggests blue light might damage collagen, a protein essential for skin structure, potentially accelerating the formation of wrinkles.
A laboratory study suggests this can happen if you hold your device one centimetre from your skin for as little as an hour.
However, for most people, if you hold your device more than 10cm away from your skin, that would reduce your exposure 100-fold. So this is much less likely to be significant.
3. Blue light can disrupt your sleep, affecting your skin
If the skin around your eyes looks dull or puffy, it’s easy to blame this directly on blue light. But as we know blue light affects sleep, what you’re probably seeing are some of the visible signs of sleep deprivation.
We know blue light is particularly good at suppressing production of melatonin. This natural hormone normally signals to our bodies when it’s time for sleep and helps regulate our sleep-wake cycle.
By suppressing melatonin, blue light exposure before bed disrupts this natural process, making it harder to fall asleep and potentially reducing the quality of your sleep.
The stimulating nature of screen content further disrupts sleep. Social media feeds, news articles, video games, or even work emails can keep our brains active and alert, hindering the transition into a sleep state.
Long-term sleep problems can also worsen existing skin conditions, such as acne, eczema and rosacea.
Sleep deprivation can elevate cortisol levels, a stress hormone that breaks down collagen, the protein responsible for skin’s firmness. Lack of sleep can also weaken the skin’s natural barrier, making it more susceptible to environmental damage and dryness.
Can skincare protect me?
The beauty industry has capitalised on concerns about blue light and offers a range of protective products such as mists, serums and lip glosses.
From a practical perspective, probably only those with the more troublesome hyperpigmentation known as melasma need to be concerned about blue light from devices.
This condition requires the skin to be well protected from all visible light at all times. The only products that are totally effective are those that block all light, namely mineral-based suncreens or some cosmetics. If you can’t see the skin through them they are going to be effective.
But there is a lack of rigorous testing for non-opaque products outside laboratories. This makes it difficult to assess if they work and if it’s worth adding them to your skincare routine.
What can I do to minimise blue light then?
Here are some simple steps you can take to minimise your exposure to blue light, especially at night when it can disrupt your sleep:
- use the “night mode” setting on your device or use a blue-light filter app to reduce your exposure to blue light in the evening
- minimise screen time before bed and create a relaxing bedtime routine to avoid the types of sleep disturbances that can affect the health of your skin
- hold your phone or device away from your skin to minimise exposure to blue light
- use sunscreen. Mineral and physical sunscreens containing titanium dioxide and iron oxides offer broad protection, including from blue light.
In a nutshell
Blue light exposure has been linked with some skin concerns, particularly pigmentation for people with darker skin. However, research is ongoing.
While skincare to protect against blue light shows promise, more testing is needed to determine if it works.
For now, prioritise good sun protection with a broad-spectrum sunscreen, which not only protects against UV, but also light.
Michael Freeman, Associate Professor of Dermatology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Undoing The Damage Of Life’s Hard Knocks
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Sometimes, What Doesn’t Kill Us Makes Us Insecure
We’ve written before about Complex PTSD, which is much more common than the more popularly understood kind:
Given that C-PTSD affects so many people (around 1 in 5, but really, do read the article above! It explains it better than we have room to repeat today), it seems like a good idea to share tips for managing it.
(Last time, we took all the space for explaining it, so we just linked to some external resources at the end)
What happened to you?
PTSD has (as a necessity, as part of its diagnostic criteria) a clear event that caused it, which makes the above question easy to answer.
C-PTSD often takes more examination to figure out what tapestry of circumstances (and likely but not necessarily: treatment by other people) caused it.
Often it will feel like “but it can’t be that; that’s not that bad”, or “everyone has things like that” (in which case, you’re probably one of the one in five).
The deeper questions
Start by asking yourself: what are you most afraid of, and why? What are you most ashamed of? What do you fear that other people might say about you?
Often there is a core pattern of insecurity that can be summed up in a simple, harmful, I-message, e.g:
- I am a bad person
- I am unloveable
- I am a fake
- I am easy to hurt
- I cannot keep my loved ones safe
…and so forth.
For a bigger list of common insecurities to see what resonates, check out:
Basic Fears/Insecurities, And Their Corresponding Needs/Desires
Find where they came from
You probably learned bad beliefs, and consequently bad coping strategies, because of bad circumstances, and/or bad advice.
- When a parent exclaimed in anger about how stupid you are
- When a partner exclaimed in frustration that always mess everything up
- When an employer told you you weren’t good enough
…or maybe they told you one thing, and showed you the opposite. Or maybe it was entirely non-verbal circumstances:
- When you gambled on a good idea and lost everything
- When you tried so hard at some important endeavour and failed
- When you thought someone could be trusted, and learned the hard way that you were wrong
These are “life’s difficult bits”, but when we’ve lived through a whole stack of them, it’s less like a single shattering hammer-blow of PTSD, and more like the consistent non-stop tap tap tap that ends up doing just as much damage in the long run.
Resolve them
That may sound a bit like a “and quickly create world peace” level of task, but we have tools:
Ask yourself: what if…
…it had been different? Take some time and indulge in a full-blown fantasy of a life that was better. Explore it. How would those different life lessons, different messages, have impacted who you are, your personality, your behaviour?
This is useful, because the brain is famously bad at telling real memories from false ones. Consciously, you’ll know that one was an exploratory fantasy, but to your brain, it’s still doing the appropriate rewiring. So, little by little, neuroplasticity will do its thing.
Tell yourself a better lie
We borrowed this one from the title of a very good book which we’ve reviewed previously.
This idea is not about self-delusion, but rather that we already express our own experiences as a sort of narrative, and that narrative tends to contain value judgements that are often not useful, e.g. “I am stupid”, “I am useless”, and all the other insecurities we mentioned earlier. Some simple examples might be:
- “I had a terrible childhood” → “I have come so far”
- “I should have known better” → “I am wiser now”
- “I have lost so much” → “I have experienced so much”
So, replacing that self-talk can go a long way to re-writing how secure we feel, and therefore how much trauma-response (ideally: none!) we have to stimuli that are not really as threatening as we sometimes feel they are (a hallmark of PTSD in general).
Here’s a guide to more ways:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Take care!
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Amid Wildfire Trauma, L.A. County Dispatches Mental Health Workers to Evacuees
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PASADENA, Calif. — As Fernando Ramirez drove to work the day after the Eaton Fire erupted, smoke darkened the sky, ash and embers rained onto his windshield, and the air smelled of melting rubber and plastic.
He pulled to the side of the road and cried at the sight of residents trying to save their homes.
“I could see people standing on the roof, watering it, trying to protect it from the fire, and they just looked so hopeless,” said Ramirez, a community outreach worker with the Pasadena Public Health Department.
That evening, the 49-year-old volunteered for a 14-hour shift at the city’s evacuation center, as did colleagues who had also been activated for emergency medical duty. Running on adrenaline and little sleep after finding shelter for homeless people all day, Ramirez spent the night circulating among more than a thousand evacuees, offering wellness checks, companionship, and hope to those who looked distressed.
Local health departments, such as Ramirez’s, have become a key part of governments’ response to wildfires, floods, and other extreme weather events, which scientists say are becoming more intense and frequent due to climate change. The emotional toll of fleeing and possibly losing a home can help cause or exacerbate mental health conditions such as anxiety, depression, post-traumatic stress disorder, suicidal ideation, and substance use, according to health and climate experts.
Wildfires have become a recurring experience for many Angelenos, making it difficult for people to feel safe in their home or able to go about daily living, said Lisa Wong, director of the Los Angeles County Department of Mental Health. However, with each extreme weather event, the county has improved its support for evacuees, she said.
For instance, Wong said the county deployed a team of mental health workers trained to comfort evacuees without retraumatizing them, including by avoiding asking questions likely to bring up painful memories. The department has also learned to better track people’s health needs and redirect those who may find massive evacuation settings uncomfortable to other shelters or interim housing, Wong said. In those first days, the biggest goal is often to reduce people’s anxiety by providing them with information.
“We’ve learned that right when a crisis happens, people don’t necessarily want to talk about mental health,” said Wong, who staffed the evacuation site Jan. 8 with nine colleagues.
Instead, she and her team deliver a message of support: “This is really bad right now, but you’re not going to do this alone. We have a whole system set up for recovery too. Once you get past the initial shock of what happened — initial housing needs, medication needs, all those things — then there’s this whole pathway to recovery that we set up.”
The convention center in downtown Pasadena, which normally hosts home shows, comic cons, and trade shows, was transformed into an evacuation site with hundreds of cots. It was one of at least 13 shelters opened to serve more than 200,000 residents under evacuation orders.
The January wildfires have burned an estimated 64 square miles — an area larger than the city of Paris — and destroyed at least 12,300 buildings since they started Jan. 7. AccuWeather estimates the region will likely face more than $250 billion in economic losses from the blazes, surpassing the estimates from the state’s record-breaking 2020 wildfire season.
Lisa Patel, executive director of the Medical Society Consortium on Climate and Health, said she’s most concerned about low-income residents, who are less likely to access mental health support.
“There was a mental health crisis even before the pandemic,” said Patel, who is also a clinical associate professor of pediatrics at Stanford School of Medicine, referring to the covid-19 pandemic. “The pandemic made it worse. Now you lace in all of this climate change and these disasters into a health care system that isn’t set up to care for the people that already have mental health illness.”
Early research suggests exposure to large amounts of wildfire smoke can damage the brain and increase the risk of developing anxiety, she added.
At the Pasadena Convention Center, Elaine Santiago sat on a cot in a hallway as volunteers pulled wagons loaded with soup, sandwiches, bottled water, and other necessities.
Santiago said she drew comfort from being at the Pasadena evacuation center, knowing that she wasn’t alone in the tragedy.
“It sort of gives me a sense of peace at times,” Santiago said. “Maybe that’s weird. We’re all experiencing this together.”
She had been celebrating her 78th birthday with family when she fled her home in the small city of Sierra Madre, east of Pasadena. As she watched flames whip around her neighborhood, she, along with children and grandkids, scrambled to secure their dogs in crates and grabbed important documents before they left.
The widower had leaned on her husband in past emergencies, and now she felt lost.
“I did feel helpless,” Santiago said. “I figured I’m the head of the household; I should know what to do. But I didn’t know.”
Donny McCullough, who sat on a neighboring green cot draped in a Red Cross blanket, had fled his Pasadena home with his family early on the morning of Jan. 8. Without power at home, the 68-year-old stayed up listening for updates on a battery-powered radio. His eyes remained red from smoke irritation hours later.
“I had my wife and two daughters, and I was trying not to show fear, so I quietly, inside, was like, ‘Oh my God,’” said McCullough, a music producer and writer. “I’m driving away, looking at the house, wondering if it’s going to be the last time I’m going to see it.”
He saved his master recording from a seven-year music project, but he left behind his studio with all his other work from a four-decade career in music.
Not all evacuees arrived with family. Some came searching for loved ones. That’s one of the hardest parts of his shift, Ramirez said. The community outreach worker helped walk people around the building, cot by cot.
A week in, at least two dozen people had been killed in the wildfires.
The work takes a toll on disaster relief workers too. Ramirez said many feared losing their homes in the fires and some already had. He attends therapy weekly, which he said helps him manage his emotions.
At the evacuation center, Ramirez described being on autopilot.
“Some of us react differently. I tend to go into fight mode,” Ramirez said. “I react. I run towards the fire. I run towards personal service. Then once that passes, that’s when my trauma catches up with me.”
Need help? Los Angeles County residents in need of support can call the county’s mental health helpline at 1-800-854-7771. The national Suicide & Crisis Lifeline, 988, is also available for those who’d like to speak with someone confidentially, free of charge.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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ADHD For Smart Ass Women – by Tracy Otsuka
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We’ve reviewed books about ADHD in adults before, what makes this one different? It’s the wholly female focus. Which is not to say some things won’t apply to men too, they will.
But while most books assume a male default unless it’s “bikini zone” health issues, this one is written by a woman for women focusing on the (biological and social) differences in ADHD for us.
A strength of the book is that it neither seeks to:
- over-medicalize things in a way that any deviation from the norm is inherently bad and must be fixed, nor
- pretend that everything’s a bonus, that we are superpowered and beautiful and perfect and capable and have no faults that might ever need addressing actually
…instead, it gives a good explanation of the ins and outs of ADHD in women, the strengths and weaknesses that this brings, and good solid advice on how to play to the strengths and reduce (or at least work around) the weaknesses.
Bottom line: this book has been described as “ADHD 2.0 (a very popular book that we’ve reviewed previously), but for women”, and it deserves that.
Click here to check out ADHD for Smart Ass Women, and fall in love with your neurodivergent brain!
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Dangers Of Root Canals And Crowns, & What To Do Instead
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Dr. Michelle Jorgensen, a dentist, tells us that it’s a lot rarer than people think to actually need a crown or a root canal; there are ways of avoiding such:
The tooth, the whole tooth, and nothing but the tooth?
First, some of the problems with the treatments that are most popular, especially in the US:
Problems with root canals:
- Involves cleaning and filling the tooth’s main canal but leaves microtubules that can harbor dead tissue and attract bacteria.
- This can lead to infections, often undetected for a long time due to the nerve removal, potentially harming overall health and weakening the tooth.
- Root canals often result in brittle teeth that can break, necessitating crowns.
And then…
Problems with crowns:
- A crown requires significant removal of tooth structure (up to 1.5 mm of enamel), making the tooth more vulnerable and sensitive.
- Crowns can also lead to new cavities underneath due to weak bonding to dentin.
- The cycle often leads from a healthy tooth to fillings, crowns, root canals, and eventual extraction (and then, perhaps, an implant in its place). That’s great for the dentist, but not so great for you.
Biomimetic dentistry the exciting name currently being used for what has been more prosaically called “conservative restorative dentistry”, which in turn has also been known by other names in recent decades, and its goal is to strengthen and preserve natural teeth as much as possible.
Methods it uses:
- Treats affected but still living teeth with non-invasive procedures.
- Uses ozone treatment to kill bacteria in deep cavities, avoiding direct nerve exposure.
- Applies conservative partial restorations like onlays instead of full crowns.
Benefits of this approach:
- Preserves enamel, minimizes trauma, and reduces the risk of tooth death.
- Maintains long-term tooth structure and health.
- 95% success rate in saving affected teeth without resorting to root canals.
In short, Dr. Jorgensen says that 60–80% of traditional crowns and root canals can be avoided. Which is surely a good thing.
For more on all of this, enjoy:
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Want to learn more?
You might also like:
Tooth Remineralization: How To Heal Your Teeth Naturally
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